Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

Daniel Martin is the Oklahoma State Police Trooper, who claimed that he may arrest the only paramedic taking care of a patient, without making any arrangements to continue the care of the patient.

Why?

Some police have defended the actions of Daniel Martin, or have claimed that it is acceptable, based on their extensive knowledge of patient care delusions of grandeur,[1] for them to make patient care decisions.

Why?

I will avoid the psychological/psychiatric explanations for this desire to practice medicine without a license. I think that the main reason is ignorance. They do not know what is going on with patient care, but rather than admit that ignorance, they decide that something must be done.

I agree that there are times when something must be done. In the absence of any immediate threat, that something should only be done after the transfer of patient care. If not, after first arranging for someone to care for the patient, the police officer/trooper should also be arrested.

Would the police go into surgery and arrest a surgeon during the middle of an operation? I hope not. So why do some feel it is acceptable for the police to make medical decisions about how sick/injured this patient is compared to a patient in surgery? Some of my patients will be more unstable than surgical patients, but a person with no training/minimal training in emergency medical assessment/treatment is not someone who has the competence to make these decisions.

We should hope that people, not trained/educated to the level to understand the medical care a patient is receiving, would seek expert advice prior to taking actions to discontinue that patient care. Even if most of the time, this police misconduct might not result in harm to the patient, that does not excuse the behavior.

Why do I bring this up now?

Maurice White Jr., 56, was booked into the Sequoyah County jail on complaints of resisting arrest, failure to obey a lawful order, speeding and failure to comply with the compulsory insurance law, Vian Assistant Police Chief Brian Chandler said.[2]

While I would like to see the dashboard cam video of this, Assistant Police Chief Chandler does seem to present the events objectively. Objectivity is an important part of professionalism that was lacking in the behavior of Trooper Daniel Martin on May 24, 2009.

Driving his personal vehicle, White was stopped for allegedly speeding around 9:15 a.m., Chandler said. While Chandler was completing a citation, White approached the police car and was asked to return to his vehicle, police said.

“I asked him again to go back to his vehicle, and he said, `What was I going to do’ if he didn’t?” Chandler said. “It went downhill from there.”[2]

Chandler said, “I treat everyone the same. The way I want to be treated. It didn’t matter who he was, he was simply not complying with me.”[3]

Which is exactly what we should expect from the police. The police should be treated with respect, even if writing a ticket that we might feel is unjustified. The time to dispute this is in court. The police should not put up with abusive treatment (and I am only going by the statements from Chandler in connecting this to the arrest of Maurice White).

For those who think that I am lacking objectivity in criticizing Daniel Martin (and those who think that Daniel Martin was correct in attempting to make patient care decisions, I have written a lot about this. Even in my original post, I stated that Maurice White contributed to the escalation that was not in the best interest of the patient.

Grandiose delusions are distinct from grandiosity, in that the sufferer does not have insight into his loss of touch with reality.

In colloquial usage, one who is said to have ‘delusions of grandeur’ is considered to be one who overestimates ones own abilities, talents or situation. This is generally due to excessive pride, rather than any actual delusions.

It will be interesting to see if this is just a case of some people, who recognized Daniel Martin, and decided to claim that he was the problem. Or whether this is evidence that Daniel Martin saw the handling of his earlier 15 minutes of fame as support from OHP (Oklahoma Highway Patrol).

One good thing. OHP has stated that they will release the dashboard cam, once their investigation is complete. Both troopers are on paid administrative leave. These are both good moves. OHP appears to have improved their understanding of supervision.

11. Trooper Martin was speeding in the same direction as the ambulance on Highway 62 in Okfuskee County, Oklahoma. Martin claimed he had an emergency which required him to run both his emergency lights and siren; however, Martin took no action when he arrived at his destination, and he only remained at his destination for less than a minute;

12. The only action taken by Martin at his destination, which was supposedly a crime scene, was that Martin took a female passenger onboard his official vehicle;

13. Before reaching his destination for a supposed crime, Martin sped up to the rear of the ambulance that was transporting the ill patient;

14. A car in front of the ambulance was pulling to the shoulder of the road, preventing the ambulance from being able to immediately pull over without risking harm to all concerned;

15. After Martin passed the ambulance, he became frustrated, got on his radio, and chastised the ambulance driver, Mr. Franks, for not pulling over quickly enough to suit Martin;

16. Martin proceeded to his destination where he did nothing other thanpick up a female passenger. Martin then immediately returned to Highway 62 with his lights on, ran a stop sign while accessing the highway, and pulled over the ambulance, which was still transporting the patient, to the side of the road;

Failure to yield immediately to a trooper on his way, with lights and sirens on, to pick up his wife.

Apparently, I have not understood the gravity of the heinous act of making a trooper late to pick up the wife at the auto repair shop, where she seems to have dropped off her car. Mea culpa.

As for a discussion of stopping the ambulance immediately, I wrote about the recklessness of that claim, at length, a couple of days ago.[2]

Honey, sorry I’m late, but I tried to get here on time. I even ran an ambulance off the road on the way here.

They had a patient on board and everything. If it will make you feel better, I can go arrest them for having the temerity to be travelling legally, and responsibly, on the road, when you are waiting. Maybe I can shoot one of them.

Please, their example of legal, safe, and responsible driving is an insult to the Oklahoma Highway Patrol!

34. Martin admitted to people at the hospital that he behaved inappropriately;

35. Thereafter, Martin submitted a false and misleading report on this matter which was released to the media;

36. Martin, through his lawyer, held a press conference in which his lawyer made false and misleading claims about Mr. White and held Mr. White in a false light

37. The Oklahoma highway Patrol has yet to take any adverse action against Martin although this matter has been pending for nearly two (2) months;

38. while reserving his right to amend and submit supplemental state claims, at present Mr. White is alleging a constitutional claim pursuant to the fourth amendment; to wit:

A. Mr. White re-alleges all of the foregoing and further states and alleges:

B. Martin seized Mr. White without cause and contrary to law;

C. Martin used unreasonable force in his seizing of Mr. White;

D. That as a result of Martin’s actions, Mr. White suffered pain and suffering, and diminution of his standing in his chosen vocation;

Why keep the OHP in suspense. They do not seem to have any understanding of what misbehavior is. They seem to think that anything done by one of their troopers is good, while any objection by any non-trooper is illegal. The statement of OHP supporting the multiple attempts at arresting Maurice White, Jr. only seems to provide further evidence of their complicity in Daniel Martin’s misbehavior.

If not for a family member with a camera phone, would any of this have come to light?

How often does something like this happen with the support of the OHP administration, but not been made public?

A rushed press release that is the day after a law suit is filed. Apparently the law suit does not involve the OHP, but just Daniel Martin. After this press conference, Maurice White, Jr. may want to focus on OHP, rather than Daniel Martin. It seems that Daniel Martin’s behavior is the kind of behavior that OHP expects from their troopers.

I guess I was wrong in my criticism of Daniel Martin’s lawyer. The Oklahoma Highway Patrol basically exonerated Daniel Martin. They just have a problem with him being caught on camera. A rushed press conference. While President Obama is on TV giving a prime time speech on health care reform. The perfect cover for them to sweep this under the rug.

OHP spokesman Capt. Christ West, reading from a news release, said Martin had a right to stop the ambulance and had justification to arrest the paramedic for obstructing an officer but that the situation could have been and should have been handled differently.[1]

In other words:

It is OK to arrest the paramedic taking care of a patient.

It is OK to chase down an ambulance and pull it over, because you thought somebody gave you the finger, even though giving the finger to OHP is not probable cause for a traffic stop (at least according to Daniel Martin’s lawyer, the guy who keeps busy defending OHP troopers against criminal charges).

When your ego is on the line, and OHP has given you a badge and a gun, you can arrest anyone you like, because public safety is not important.

Martin’s demeanor and language were unprofessional and contrary to what is expected of an Oklahoma Highway Patrol trooper by both the Department of Public Safety and the public, West said.[1]

It took OHP administration almost 3 months to recognize this?

It only took Daniel Martin 11 seconds to arrive at a crime scene, come to the conclusion he had more important things to do, and go chasing after an ambulance for something that is not even justification for a traffic stop.

OHP is obviously not in the same league as Daniel Martin. They are slow.

It would have been more appropriate to allow the ambulance to continue to the hospital immediately once he knew that a patient was on board, West said.[1]

Really?

They didn’t want Daniel Martin to shoot out the tires, launch some tear gas into the patient compartment, fasten a bayonet to his sidearm, and take no prisoners? Argh! Double Argh!

Really?

He did not take questions after he read the statement.[1]

What could this public information officer possibly say to defend what he just read?

Maurice White, Jr., I do not agree with everything you did, but you do not deserve this kind of treatment from the OHP. I’m no lawyer, but I think it might be a good idea to add OHP to the law suit.

A review of the video tape supports your belief that probable cause existed to stop the ambulance for failure to yield to an emergency vehicle. The ambulance had no emergency equipment activated and there was no indication that the ambulance had any patient on board. There was legal basis to stop the ambulance.[2]

I recommend that OHP implement some vision testing for the administrative personnel involved in this decision. Perhaps they have glaucoma and have been smoking too much medical marijuana to treat their impaired vision.

Consider the alleged infraction. Failure to yield. OHP states that the vehicle must immediately yield.

Immediately is an interesting word. It suggests that the driver should not consider anything except getting out of the way, but what if there are pedestrians on the side of the road? Animals? You hit a medium sized dog in a car and you may be deflected back in front of the trooper. What if a car in front of you is slowing down and pulling over faster than you can safely slow down and pull over in a much larger vehicle, such as one that regularly transports emergency patients, commonly known as an ambulance? Does anyone believe that unsafe driving is required in order to pull over immediately?

What about distractions to the driver of the emergency vehicle? OHP troopers do like to babble on about an ambulance doing some sort of magical reassembly, when the lights and sirens are turned on/off. Yet, an ambulance is still an ambulance with all of the emergency equipment, including emergency radios. Those emergency radios, plus a family member up front, plus communication with a partner in the back, plus communication with a hospital, plus communication with dispatch, plus the noise of the diesel engine, plus the insulation of having this large box on the back of the ambulance, mean that there is going to be a delay in hearing any sirens. Even if Daniel Martin were driving the ambulance, there would be a significant delay in hearing the sirens.

Then there are the visual impairments. A large box on the back of the ambulance that makes it difficult to see to the rear on a straight road, but on the turn where this occurred, this box guarantees that the person driving the ambulance will have almost no warning that someone is approaching with their lights on. The mirrors on a truck are not good at seeing around turns. Perhaps the administration of OHP may have some plan to repeal the laws of physics, but I do not expect them to be successful.

If immediately is to be interpreted literally, that would be irresponsible. While we should be as aware as possible of our surroundings and notice lights and sirens approaching instantly, there are many distractions when driving an ambulance. Several of these distractions combined will make it unlikely that even experienced OHP troopers would have noticed the lights and sirens immediately, never mind the impossible task of being able to pull over immediately. Pulling over immediately can only rarely be done with due regard for the safety of others.

To pull over immediately probably would have been reckless. I suspect that reckless driving is a more serious violation of the Oklahoma motor vehicle code than failure to yield. On the other hand, the ego of a trooper is more important to administration, than the welfare of a patient. Almost 3 months of paid time off.

The driver of the ambulance is responsible for the safety of the occupants of the ambulance and the other drivers on the road. Sudden, or immediate, changes in direction are a bad idea. It appeared to me as if Paul Franks pulled to the side as soon as it was safe after he became aware of the trooper. I did not see anything in the video to contradict that. Why would he pull over before he became aware of the trooper? We do not know when he became aware of the lights and sirens, but can only guess. Unless you claim psychic powers, you do not know either. He cannot respond to something he is not aware of.

Pulling to the side of the road does not relieve him of his obligation to drive safely. He swerved around a vehicle to avoid hitting it, but did not signal. Perhaps that was because he was surprised by the behavior of the driver of that vehicle.

The important thing is that these are questions that should be addressed, if at all, at the hospital after the transfer of patient care. Anything else is incompetence.

Then there is the question of what would happen in a court room. A judge, who does not work for OHP, is probably going to throw this out immediately. OK, maybe not immediately. The judge may take some time to provide a verbal spanking to the trooper for wasting the judge’s time, wasting the ambulance crew’s time, wasting the tax payer’s money, and endangering the patient.

It seems that paramedic Maurice White, Jr. is not satisfied with the way the Oklahoma Highway Patrol is handling the events of May 24 of this year.

Three months ago.

Trooper Daniel Martin is still on paid administrative leave. I understand that a part of the reason is the threats made against Daniel Martin and his family. I do not support making any threats. However, I could use 3 months of paid time off myself. Whom do I have to choke to get some of that?

Yet, for some reason the 911 call taker for the Lincoln Park Police Department loses his cool and hangs up on the caller. Again and again.*

She runs down the street to the police station to try to get what she was calling for – an ambulance – and she is arrested.

That’ll teach her to call 911 about a medical emergency!

Here is the video with the recording of the 911 calls.

I agree that the girl, Adrianne Ledesma, sure does not seem to get the picture, either. Her father just had brain surgery and is now having a seizure, but she is worried about suing the guy on the phone. Maybe Dad should sue over this, but have a lawyer prevent his daughter from receiving any of this money.

It is not at all clear if the father is still seizing, or was ever seizing, or how often this happens, but this kid needs to start acting responsibly. If you have a family member with a medical condition, you need to learn to deal with it, not try to figure out whom you might sue for giving you a hard time.

The police officer, Seargent Robert McFarlan, must have a doozy of an excuse. He has been working for 20 years (5 years longer than Daniel Martin). He may not have any skeletons in his closet. He refused to comment.

What is his job?

His job is to dispatch the appropriate people to deal with whatever emergencies occur during his shift. His job is to calm down people on the other end of the phone, so that he may obtain the information he needs. Once he knows there is a request for an ambulance, he should start sending the ambulance. I am guessing that Lincoln Park has Enhanced 911, which is a form of caller ID. He does not know what is going on, but there has been a request for an ambulance.

Wouldn’t it be nice if I could refuse to deal with people if they used less than polite language. I wouldn’t even get to a lot of the calls with the language used by some of my partners.

Assuming that we did make it to the call without expletive, the families, by-standers, and patients have been known to use the occasional indelicate expression. I have been yelled at repeatedly for taking too long because the patient was not white. Not that dispatch provides that kind of information, or even asks for it, but some people have priorities that have nothing to do with the patient. They just use the patient as an excuse to cause trouble, such as to sue.

The malice of these by-standers is not the fault of the patient.

This is a part of the job. If we feel threatened, it is appropriate to leave until police arrive and deal with whatever violence/potential violence is there. Of course, if I am on the other end of a phone, am I in any danger?

The refreshing news on this is that the Chief of Police has been open about dealing with this. This is not the Oklahoma Highway Patrol.

It is important to note that Sgt. McFarlan has had a career of meritous service, has never had a disciplinary action until this incident, and was suspended without pay for two weeks and sent for training after this incident.[1]

Never had a disciplinary action in 20 years? How many people can claim that? But what happened on this call?

As part of this post, I would like to include another pointer. The times when you should probably not get yelled at for using foul language include just about every legitimate reason to call 911. There is no justification for 911 acting as Miss Manners, especially since Seargent McFarlan uses obscenity during the 911 call, too.

Here is an imaginary call to the 911 Hypocrisy Line.

911 – Hello, 911 Hypocrisy Line, how may I help you?

Caller – I need a *&%$#@ ambulance.

911 – Hold on there, Missy. I’m not gonna put up with that $#!+. You’re going to have to call back again and act like a professional this time.

911 call takers do put up with a lot of abuse on the phone. I am not defending abuse of 911 in any way. I wonder how many times they hear the words, Thank you, at the end of a call. They deserve our thanks. They do not deserve to be lumped in with the few who make the news for bad judgment.

^* David Konig has a different take on whether the hang up is by the 911 call taker or the caller. If the caller hung up, what was she thinking? That is a rhetorical question. We all know that she was not thinking. Maybe it is due to the emergency, but what does hanging up accomplish? The link is below [1]

For those not familiar with the Oklahoma Highway Patrol and Daniel Martin references, use the search box in the upper left of the browser window. You will get more information than you ever wanted on OHP and Daniel Martin.

Earlier today I wrote about the background of Maurice White, Jr. Now the background of Daniel Martin.

This is from the Tulsa World:

Longtime Fairfax barber shop owner Linda Bevill described Martin as a bullish man who ran off teenagers from cruising Main Street and constantly accused residents of drinking alcohol during an endless stream of “unnecessary” traffic stops.

“He struck me as a man who probably didn’t have any control over any part of his life growing up, someone who needed control and power,” Bevill said. “I remember he even went and bought one of those portable police lights for his own car. He just needed to play cop even when he was off duty.

“He needed to be admired, but he could never figure out why people didn’t like him. He just didn’t have any feel for people. And he was always making something big out of nothing.”

Former board of trustees member Ted Smith remembered Martin as someone who “didn’t take orders very well.”

Smith recalled one incident he witnessed in which two handcuffed teenagers were lying facedown on the sidewalk. Martin stood over one of the youngsters with his pistol aimed at the youth’s head.

“The boys were already handcuffed and on the ground,” Smith said. “Why pull the gun? … Yeah, we had a lot of trouble with him. We’re not surprised at all by what has happened. He just had an attitude.[1]

Some of these are just a waste of ink, Longtime Fairfax barber shop owner Linda Bevill described Martin as a bullish man who ran off teenagers from cruising Main Street.

I know plenty of people who would say that is the job of the police. Is this a problem? I do not know and cannot decide from the information provided.

and constantly accused residents of drinking alcohol during an endless stream of “unnecessary” traffic stops.

If people are drinking and driving, are the police supposed to ignore this. I have worked in a rich town, where drunk driving is treated very leniently. Should the police ignore drunk drivers?

Or is Daniel Martin making up stuff about drivers consuming alcohol? I don’t know, but where is the reporter providing some information to help inform the reader?

The only comment that seems to provide any information is the one from Former board of trustees member Ted Smith. There is no mention of any documentation on this incident. It would be nice to have something to back up the statement by this former official. What were the details of this incident?

Martin’s defense attorney, Gary James, portrayed him last week as a loving family man and an American hero who recently returned from Iraq after a tour of duty as a U.S. naval reservist. Residents of the rural Osage County town of Fairfax have dramatically different recollections of Martin, who was their police chief from March 1999 to July 2000.

Martin’s tenure in Fairfax ended with a unanimous vote for his firing.

“Yeah, I remember him,” store clerk Linda Burgess said. “That’s a sore subject around here. He left quite an imprint on this community, and not a good one, either. He was a bully with an attitude.

“And he was always pulling people over and using the f-word.”[1]

Other than the report of his firing, this quote does not seem to be any more accurate information than I might be able to get by going down to a local bar during the day and asking for opinions on a local police officer. This audience may be much more likely to have people willing to talk and at the same time likely to have had a bad experience with any police officer. That does not make it news. I expect that there will be some more digging into their backgrounds, because this is a lot of reporting of rumors. Maybe there is something behind the rumors, but let’s have something to convince us that these rumors have some substance. This seems as if it was rushed to get something in print. This seems to be something that should not have been rushed.

Both Daniel Martin and Maurice White, Jr. have been fired from jobs. Both seem to have been around for a long time with mostly uneventful job histories. Outside of the statement about the handcuffed teens being menaced with a gun and the firings, I do not see anything here that might have led OHP or Creek Nation to decide that either was a poor choice for the job. Of course, they do not make their decisions based just on an article in the paper.

I feel a Clara Peller moment coming on.

Dave Statter at STATter 911 still seems to be the source for the most complete and most up to date information.

Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.

- Thomas Jefferson

Notes on the State of Virginia (1781-1783)

-

Bigotry and science can have no communication with each other, for science begins where bigotry and absolute certainty end. The scientist believes in proof without certainty, the bigot in certainty without proof. Let us never forget that tyranny most often springs from a fanatical faith in the absoluteness of one’s beliefs.

Ashley Montagu.

-

Today we rely less on superstition and tradition than people did in the past, not because we are more rational, but because our understanding of risk enables us to make decisions in a rational mode.

- Peter L. Bernstein

Against the Gods: the remarkable story of risk (1996)

-

Mark my word, if and when these preachers get control of the [Republican] party, and they're sure trying to do so, it's going to be a terrible damn problem. Frankly, these people frighten me. Politics and governing demand compromise. But these Christians believe they are acting in the name of God, so they can't and won't compromise. I know, I've tried to deal with them.

Barry Goldwater.

-

I think every good Christian ought to kick Falwell right in the ass.

Barry Goldwater

Said in July 1981 in response to Moral Majority founder Jerry Falwell's opposition to the nomination of Sandra Day O'Connor to the Supreme Court, of which Falwell had said, "Every good Christian should be concerned." as quoted in Ed Magnuson, "The Brethren's First Sister," Time Magazine, (20 July, 1981)

-

What do you think science is? There's nothing magical about science. It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?

Dr. Steven Novella.

-

What progress we are making. In the Middle Ages they would have burned me. Now they are content with burning my books.

Sigmund Freud (1933)

Today the samizdat is digital and burning a copy has the opposite meaning. A little later, persecution of the Jews was once again the law - Freud's four sisters all died in concentration camps, although not by burning.

-

"Can you prove that it’s impossible?” “No”, I said, “I can’t prove it’s impossible. It’s just very unlikely”. At that he said, “You are very unscientific. If you can’t prove it impossible then how can you say that it’s unlikely?” But that is the way that is scientific. It is scientific only to say what is more likely and what less likely, and not to be proving all the time the possible and impossible. To define what I mean, I might have said to him, "Listen, I mean that from my knowledge of the world that I see around me, I think that it is much more likely that the reports of flying saucers are the results of the known irrational characteristics of terrestrial intelligence than of the unknown rational efforts of extra-terrestrial intelligence." It is just more likely. That is all.

Richard Feynman.

The Character of Physical Law (1965)
chapter 7, “Seeking New Laws,” p. 165-166:

It has been over half century since Feynman explained this. The reports of flying saucers have continued, but there is still no valid evidence to support belief in flying saucers. Feynman's explanation is a good definition of unlikely.

-

An ignorant mind is precisely not a spotless, empty vessel, but one that’s filled with the clutter of irrelevant or misleading life experiences, theories, facts, intuitions, strategies, algorithms, heuristics, metaphors, and hunches that regrettably have the look and feel of useful and accurate knowledge.

David Dunning - explaining the Dunning-Kruger effect.

-

Treat beliefs not as sacred possessions to be guarded but rather as testable hypotheses to be discarded when the evidence mounts against them.

Philip Tetlock.

-

Squatting in between those on the side of reason and evidence and those worshipping superstition and myth is not a better place. It just means you’re halfway to crazy town.

PZ Myers

-

The legitimate powers of government extend to such acts only as are injurious to others. But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg.

Thomas Jefferson.

-

Imagine a world in which we are all enlightened by objective truths rather than offended by them.

Neil deGrasse Tyson

-

Education is a progressive discovery of our own ignorance.

Will Durant.

-

You don't use science to show that you're right,

you use science to become right.

Randall Munroe

-

Just because science doesn't know everything doesn't mean you can fill in the gaps with whatever fairy tale most appeals to you.

There appears to be in mankind an unacceptable prejudice in favor of ancient customs and habitudes which allows practices to continue long after the circumstances, which formerly made them useful, cease to exist

Benjamin Franklin.

-

If science proves some belief of Buddhism wrong,

then Buddhism will have to change.

Tenzin Gyatso, 14th Dalai Lama.

-

Ridicule is the only weapon which can be used against unintelligible propositions. Ideas must be distinct before reason can act upon them;

Thomas Jefferson.

-

Science doesn't make it impossible to believe in God.

It just makes it possible to not believe in God.

Stephen Weinberg.

-

There are no forbidden questions in science,

no matters too sensitive or delicate to be probed,

no sacred truths.

Carl Sagan.

-

The legitimate powers of government extend to such acts only as are injurious to others. But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg.

Thomas Jefferson.

-

It is better to not understand something true,
than to understand something false.

Neils Bohr.

-

God does not play dice with the universe.

Albert Einstein

Stop telling God what to do with his dice.

response by Neils Bohr.

-

All things are poison and nothing is without poison, only the dose permits something not to be poisonous.

Paracelsus.

-

What is not true, as everyone knows, is always immensely more fascinating and satisfying to the vast majority of men than what is true.

H.L. Mencken.

-

Every valuable human being must be a radical and a rebel, for what he must aim at is to make things better than they are.

Niels Bohr.

-

How wonderful that we have met with a paradox. Now we have some hope of making progress.

Niels Bohr.

-

An expert is a man who has made all the mistakes which can be made in a very narrow field.

Niels Bohr.

-

Every sentence I utter must be understood not as an affirmation, but as a question.

Niels Bohr.

-

Some subjects are so serious that one can only joke about them.

Niels Bohr.

-

I have no special talents. I am only passionately curious.

Albert Einstein.

-

Few people are capable of expressing with equanimity opinions which differ from the prejudices of their social environment. Most people are even incapable of forming such opinions.

Albert Einstein.

-

Never memorize what you can look up in books.

Albert Einstein.

-

The prestige of government has undoubtedly been lowered considerably by the prohibition law. For nothing is more destructive of respect for the government and the law of the land than passing laws which cannot be enforced. It is an open secret that the dangerous increase of crime in the United States is closely connected with this.

Albert Einstein.

-

the chance is high that the truth lies in the fashionable direction. But, on the off-chance that it is in another direction - a direction obvious from an unfashionable view of field theory - who will find it? Only someone who has sacrificed himself by teaching himself quantum electrodynamics from a peculiar and unusual point of view; one that he may have to invent for himself. I say sacrificed himself because he most likely will get nothing from it, because the truth may lie in another direction, perhaps even the fashionable one.

If you've made up your mind to test a theory, or you want to explain some idea, you should always decide to publish it whichever way it comes out. If we only publish results of a certain kind, we can make the argument look good. We must publish both kinds of results.

If a reasonable launch schedule is to be maintained, engineering often cannot be done fast enough to keep up with the expectations of originally conservative certification criteria designed to guarantee a very safe vehicle. In these situations, subtly, and often with apparently logical arguments, the criteria are altered so that flights may still be certified in time. They therefore fly in a relatively unsafe condition, with a chance of failure of the order of a percent (it is difficult to be more accurate).

Official management, on the other hand, claims to believe the probability of failure is a thousand times less. One reason for this may be an attempt to assure the government of NASA perfection and success in order to ensure the supply of funds. The other may be that they sincerely believed it to be true, demonstrating an almost incredible lack of communication between themselves and their working engineers.

Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.

Richard Feynman.

-

Science alone of all the subjects contains within itself the lesson of the danger of belief in the infallibility of the greatest teachers in the preceding generation ... Learn from science that you must doubt the experts. As a matter of fact, I can also define science another way:

Science is the belief in the ignorance of experts.

Richard Feynman.

-

The only way to have real success in science, the field I’m familiar with, is to describe the evidence very carefully without regard to the way you feel it should be. If you have a theory, you must try to explain what’s good and what’s bad about it equally. In science, you learn a kind of standard integrity and honesty.

Richard Feynman.

-

Some people say, "How can you live without knowing?" I do not know what they mean. I always live without knowing. That is easy. How you get to know is what I want to know.

Richard Feynman.

-

I don't know anything, but I do know that everything is interesting if you go into it deeply enough.

Richard Feynman.

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So, to test the prevailing intellectual standards, I decided to try a modest (though admittedly uncontrolled) experiment: Would a leading North American journal of cultural studies . . . publish an article liberally salted with nonsense if (a) it sounded good and (b) it flattered the editors' ideological preconceptions?

Common sense in matters medical is rare, and is usually in inverse ratio to the degree of education.

William Osler.

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The greater the ignorance the greater the dogmatism.

William Osler.

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The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.

William Osler.

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One of the first duties of the physician is to educate the masses not to take medicine.

William Osler.

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In the fields of observation chance favors only the prepared mind.

Louis Pasteur.

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Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world. Science is the highest personification of the nation because that nation will remain the first which carries the furthest the works of thought and intelligence.

Louis Pasteur.

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Not far from the invention of fire must rank the invention of doubt.

Thomas Henry Huxley.

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The great tragedy of Science — the slaying of a beautiful hypothesis by an ugly fact.

Thomas Henry Huxley.

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The foundation of morality is to have done, once and for all, with lying; to give up pretending to believe that for which there is no evidence, and repeating unintelligible propositions about things beyond the possibilities of knowledge.

Thomas Henry Huxley.

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My business is to teach my aspirations to conform themselves to fact, not to try and make facts harmonise with my aspirations.

Thomas Henry Huxley.

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There must have been a time, in the beginning, when we could have said – no. But somehow we missed it.

Tom Stoppard

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All men can be criminals, if tempted; all men can be heroes, if inspired.

G. K. Chesterton

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There is no such thing on earth as an uninteresting subject; the only thing that can exist is an uninterested person.

G. K. Chesterton

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Good taste, the last and vilest of human superstitions, has succeeded in silencing us where all the rest have failed.

G. K. Chesterton

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Men become superstitious, not because they have too much imagination, but because they are not aware that they have any.

George Santayana

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If we are uncritical we shall always find what we want: we shall look for, and find, confirmations, and we shall look away from, and not see, whatever might be dangerous to our pet theories. In this way it is only too easy to obtain what appears to be overwhelming evidence in favor of a theory which, if approached critically, would have been refuted.

Karl Popper

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It is difficult to get a man to understand something, when his salary depends upon his not understanding it!

Upton Sinclair

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Freedom is what you do with what's been done to you.

Jean-Paul Sartre

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Where goods do not cross frontiers, armies will.

Frédéric Bastiat

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The ultimate result of shielding men from the effects of folly is to ﬁll the world with fools.

Herbert Spencer

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Political language — and with variations this is true of all political parties, from Conservatives to Anarchists — is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.

George Orwell

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Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.

John Adams

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We're not presuming the answers before we ask the questions.

Lawrence Krauss explaining how science works

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Malo Periculosam Libertatem Quam Quietum Servitium.

Better freedom with danger than peace with slavery.

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Whatever inspiration is, it's born from a continuous "I don't know."

Wislawa Szymborska

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All sorts of torturers, dictators, fanatics, and demagogues struggling for power by way of a few loudly shouted slogans also enjoy their jobs, and they too perform their duties with inventive fervor.

Well, yes, but they "know." They know, and whatever they know is enough for them once and for all.

They don't want to find out about anything else, since that might diminish their arguments' force.

Wislawa Szymborska.

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Theory helps us to bear our ignorance of fact.

George Santayana

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Miracles are propitious accidents, the natural causes of which are too complicated to be readily understood.

George Santayana.

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Fanaticism consists in redoubling your efforts when you have forgotten your aim.

George Santayana

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There is a fundamental difference between religion,

which is based on authority,

and science,

which is based on observation and reason.

Science will win because it works.

Stephen Hawking.

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The truth, indeed, is something that mankind, for some mysterious reason, instinctively dislikes. Every man who tries to tell it is unpopular, and even when, by the sheer strength of his case, he prevails, he is put down as a scoundrel.

H.L. Mencken.

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It is the natural tendency of the ignorant to believe what is not true. In order to overcome that tendency it is not sufficient to exhibit the true; it is also necessary to expose and denounce the false.

I am attempting to make it easier, when I use footnotes, to navigate to the information in a footnote, look at the information, and return to where you were before you clicked on the footnote. If you click on the number of a footnote in the text[1] <- click on the bracketed and underlined number - in this case [1], it will bring the footnote to the top of the screen.

[1] If you click on the bracketed and underlined number of a footnote in footnote section, the [1] at the beginning of this paragraph, it will take you to where you clicked on the footnote in the text, with the footnote along the top of the screen. [To top of footnotes]

If you wish to modify the size of the text, you can press the CTRL key and roll the mouse wheel forward or back, or you can press the CTRL key and the + or - keys to make text larger or smaller. Another way is to adjust the font in your browser controls.

This is a mostly medical blog, so here is the HIPAA incantation to ward off evil whiny HIPAA-obsessed spirits.

HIPAA (Health Insurance Portability and Accountability Act of 1996) is generally misrepresented by those in health care, but there are no violations of HIPAA here. There are some patients I could not discuss without changing details, so details may be omitted, or changed. That may decrease the dramatic effect of some of what I write, but patients are entitled to their privacy and have been since before HIPAA became the ignorant administrators' justification for imitating a two year old yelling NO!

I am not dispensing medical advice. If you get your medical advice off of a blog, instead of consulting a physician (such as your medical director), you probably should not be treating anyone, not even yourself. I could include your dog, but that would suggest that veterinarians do not provide excellent care. The veterinarians I know take pride in the care they deliver and deliver excellent care, more so than many people I know in EMS.

I do point you to research to support what I write, but you still need to make sure that you have the authorization of your medical director before changing any of your treatments. If your medical director does not agree, you can point to the research I write about. Most doctors do understand research, they just have trouble keeping up with the amount of research that is produced.

What I write does not change your protocols. If you do not like a protocol, take it up with the medical director. I have several inadequate protocols, too. I call medical command and attempt to persuade the physician that what I am requesting is in the best interest of the patient. It is rare that I am turned down, but the dose is often inadequate. I call back before I need more, so the patient does not have to put up with the On Line Medical Command delay in treatment. Health care providers should be anticipating where the care of the patient is headed - both for good and for bad.

I do not have any connection to the products I mention, other than using them and being satisfied, dissatisfied, or some combination of the two. If I have any potential conflict of interest, I will mention it clearly.

If I write about a book by an author I know, I will encourage you to buy the book from the author's web site. This means that any money goes to the author (or to where the author wants the money to go, such as a charity) and you have an opportunity to sample the author's writing for free on the author's blog before buying the book.

I may be blunt, but I do not intend it personally. There are few mistakes that can be made that I have not made. I continue to try not to be stupid; you may conclude that I fail.

I welcome any relevant comments and much that is not relevant. I reserve the right to delete any inappropriate comments. I decide what is appropriate based on my own nebulous standards. Criticism of ideas is expected. Criticism of writing style is appreciated.

I avoid obscenity because I believe that the English language provides enough opportunities for creativity that resorting to the words that may not be said on TV (and a growing group of words that may) is unnecessary. I may quote something that contains some of these words, or I may link to something that does, but that is as bad as I expect to be with these words.

On the other hand, you may feel that the ideas I present are offensive. My aim is to encourage thought, dialogue, and creativity - not to tell you everything is OK. You may leave this blog at any time and bury your mind in comfortable, familiar ideas.

If you feel that the ideas I present are not challenging, please encourage me to address whatever you feel I do not adequately address.